Abstract:
:Patients with atrial fibrillation (AF) have an increased stroke risk compared with those in sinus rhythm, although the absolute risk for individual patients is modulated by the presence of various additional risk factors. Patient selection for oral anticoagulation for stroke prevention is based on risks of stroke and bleeding. Although CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack) is the most widely used scheme for evaluating stroke risk in patients with AF, several other stroke risk factors are not included; therefore, many patients' stroke risk may be underestimated, contributing to the underuse of anticoagulants. Furthermore, a substantial proportion of patients are categorized as being at moderate risk (CHADS2 = 1), and there has been some ambiguity regarding optimum thromboprophylaxis in this group. The refinement of CHADS2 , CHA2 DS2 -VASc (Congestive heart failure, Hypertension, Age 75 years [2 points], Diabetes mellitus, Stroke or transient ischemic attack [2 points], Vascular disease, Age 65 to 74 years, Sex category [female]), considers additional risk factors. Its main advantage is its ability to identify patients truly at low risk of thromboembolism (CHA2 DS2 -VASc = 0), who are unlikely to benefit from antithrombotic therapy. For all others, an oral anticoagulant may be the preferred approach, simplifying clinical decision making. Implementation of CHA2 DS2 -VASc may also result in an increased proportion of patients receiving anticoagulation. The emergence of newer oral anticoagulants that can be given without routine coagulation monitoring, with improved benefit-risk profiles vs vitamin K antagonists, promises to simplify therapy for patients with AF at risk of stroke. This, coupled with advances in stroke risk stratification, is expected to improve patient outcomes and reduce the burden of AF-related stroke.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Verheugt FWdoi
10.1002/clc.22122subject
Has Abstractpub_date
2013-06-01 00:00:00pages
312-22issue
6eissn
0160-9289issn
1932-8737journal_volume
36pub_type
杂志文章,评审abstract::The purpose of this study was to evaluate the antihypertensive effect of a new calcium antagonist, clentiazem, on inpatients or outpatients with essential hypertension. After blood pressure was stable and greater than 160/95 mmHg with placebo for at least a 2-week observation period, oral clentiazem was administered o...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/clc.4960140112
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Due to sensorial autonomic neuropathy, the type and severity of angina pectoris in patients with diabetes mellitus (DM) may be rather different from the type and severity of angina pectoris in patients without DM. HYPOTHESIS:The aim of the study was to understand if angina pectoris is related to extensive c...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22151
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Acute aortic dissection (AAD) is a life-threatening medical emergency that requires immediate diagnosis and rapid treatment. There is a paucity of data on the role of biomarkers in risk stratification of patients with AAD. HYPOTHESIS:N-terminal pro-brain natriuretic peptide (NT-proBNP) is associated with sh...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23436
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Aortic valve disease is an important and frequent clinical problem with a mortality rate as high as 50-80% in a 5-year natural history of patients with severe aortic valve disease. Biological or mechanical prosthesis implantation is the only way to improve prognosis. HYPOTHESIS:The aim of our study was to a...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960201010
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Low levels of high-density lipoprotein cholesterol (HDL-C; <40 mg/dL) are associated with increased risk of cardiovascular events, but it is unclear whether lower thresholds (<30 mg/dL) are associated with increased hazard. HYPOTHESIS:Very low levels of HDL-C may provide prognostic information in acute coro...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22533
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Numerous evidence has suggested that either hypertension or atrial fibrillation (AF) is associated with systemic inflammation. Peroxisome proliferator-activated receptor-gamma (PPARgamma) has been proved to have anti-inflammatory effects and is implicated as a molecular pathway involved in many cardiovascula...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20566
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Conventional approaches to management of congestive heart failure (CHF) rely on drugs that increase myocardial contractility or reduce ventricular afterload. These approaches often improve cardiac symptoms and survival, but may be associated with significant deleterious effects. An alternative approach is to...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960211206
更新日期:1998-12-01 00:00:00
abstract::The coronary sinus (CS) is a small tubular structure just above the posterior left atrioventricular junction. The CS can be imaged in several different echocardiographic views. Using zoom M-mode recordings of the CS in apical two-chamber view, CS caliber can be sharply imaged and easily measured during different phase...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960230304
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Therapeutic angiogenesis, if combined with primary percutaneous transluminal coronary angioplasty or stent placement, could improve the outcome of patients suffering from multifocal coronary disease. HYPOTHESIS:Because of the concern that angiogenic growth factors might promote restenosis, we studied the ef...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960250606
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:The poor clinical outcome in acute myocardial infarction (AMI) patients undergoing primary percutaneous coronary intervention (PCI) has been attributed to myocardial ischemia-reperfusion injury (MIRI). OBJECTIVE:This study aimed to identify the predictive factors of MIRI during PCI in Chinese AMI patients w...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20294
更新日期:2009-03-01 00:00:00
abstract::On the basis of our reported experience with colchicine for recurrent pericarditis, we administered colchicine to two patients with large pericardial effusions complicating idiopathic pericarditis. The first was a 26-year-old male who showed clinical deterioration following emergency pericardiocentesis and aspirin (3 ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960210220
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:The prognostic ability of cardiac troponin I (TnI) has been demonstrated in general populations and among cardiovascular disease patients, but it has not been evaluated in cancer patients. HYPOTHESIS:This study assumes to have the prognostic ability of cardiac troponin in cancer patients visiting the emerge...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23486
更新日期:2020-12-01 00:00:00
abstract::Although certain classes of drugs appear to possess benefits apart from their blood-pressure lowering capability, reduction of blood pressure remains the single most important action of antihypertensive therapy. Calcium-channel blockers (CCBs) have long been recognized as potent agents for hypertension therapy. This i...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960261404
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Disruption of the atherosclerotic plaque is a common feature of both acute coronary syndromes and balloon dilatation of coronary artery stenoses. HYPOTHESIS:The study was undertaken to evaluate whether the known association of cholesterol levels and acute coronary syndromes also exists for the occurrence of...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4950260708
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) reduce perioperative cardiac events in high-risk patients undergoing cardiovascular surgery. However, there is paucity of data on the role of statins in patients undergoing intermediate-risk noncardiac, nonvascular surgery (NCNVS). HYPOTHESIS:S...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22135
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that viable but stunned myocardium displays contractile reserve and exhibits cardiac cycle-dependent variations of integrated backscatter (CVIB), whereas infarcted myocardium does not. HYPOTHESIS:This study was designed to clarify whether assessment of the acoustic properties of ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960261010
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:The aim of this study was to define the prevalence of previously undetected coronary heart disease among asymptomatic males, aged 30-65 years, by means of resting and exercise electrocardiography in conjunction with an analysis of conventional and exertional coronary risk factors. METHODS:Bet...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190405
更新日期:1996-04-01 00:00:00
abstract::Treatment advances for severe symptomatic aortic stenosis including transcatheter and open surgical valve replacement have improved patient survival, length of stay, and speed to recovery. However, paravalvular regurgitation (PVR) is occasionally seen and when moderate or greater in severity is associated with an at l...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.23504
更新日期:2021-01-01 00:00:00
abstract::The severity and site of hypertrophy is important in determining the clinical picture and the natural history of hypertrophic cardiomyopathy (HCM). We evaluated left ventricular hypertrophy by means of two-dimensional echocardiographic score and score index, and correlated these findings with symptoms, electrovector-c...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120809
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:In addition to the well-investigated proinflammatory cytokine expression, there is an ever increasing interest in the field of anti-inflammatory response to cardiopulmonary bypass (CPB). Evidence suggests that myocardium serves as an important source of cytokines during reperfusion and application of CPB. Th...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960290708
更新日期:2006-07-01 00:00:00
abstract::Survival to adulthood is very rare in tricuspid atresia, particularly in certain subtypes and in the presence of Eisenmenger's physiology. We report a 32-year-old woman who has the type IC variant of tricuspid atresia and who has had documented Eisenmenger's physiology for over 10 years. ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960071007
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Current National Cholesterol Education Program (NCEP) guidelines recognize low-density lipoprotein cholesterol (LDL-C) below 100 mg/dl as an optimal level. Evidence supporting this is scant. Both LDL-C and C reactive protein (CRP) are known correlates of atherosclerosis progression. HYPOTHESIS:We examined t...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960270105
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Triage decisions for chest pain patients receiving usual care are based on a dynamic and comprehensive strategy performed in the physician's mind. It remains controversial whether simple, structured risk tools can surpass real, complex judgments. HYPOTHESIS:The potentially used History, Electrocardiogram, A...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.23325
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF), a disease of the elderly, occasionally occurs at younger age. Pathophysiology of AF in younger patients is diverse, including channelopathies and cardiomyopathies. Data on the significance and complications of AF in young patients are scarce. HYPOTHESIS:Atrial fibrillation is the f...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22516
更新日期:2016-04-01 00:00:00
abstract::Coronary collateral perfusion to the completely obstructed coronary artery was evaluated by coronary cineangiography in 32 patients. In 13 patients, there was neither history of severe chest pain of longer than 30-min duration nor electrocardiographic evidence of a transmural myocardial infarction (Group I). Among pat...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960100705
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:The normal and dilated heart behaves as a single functional unit during preload reduction: volume unloading in the setting of diastolic ventricular interaction allows for increased left ventricular (LV) filling. HYPOTHESIS:We hypothesized that reduction of venous return induced by a physiologic stimulus (ti...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960260909
更新日期:2003-09-01 00:00:00
abstract::Patients with acute coronary syndrome (ACS) usually receive acetylsalicylic acid plus an adenosine diphosphate (ADP) receptor inhibitor to reduce the long-term risk of recurrent events. However, patients receiving standard antiplatelet prophylaxis still face a substantial risk of recurrent events. Strategies involving...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.22233
更新日期:2014-03-01 00:00:00
abstract::The incidence of inadvertent permanent ventricular pacing from the coronary vein is not known. In a retrospective analysis of 69 patients in whom transvenous pacemakers were implanted between 1979 and 1986, 12 patients were discovered to have right bundle-branch block pattern to the paced complexes on electrocardiogra...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120508
更新日期:1989-05-01 00:00:00
abstract::An unusual case of metastatic disease of the right ventricle is described in a 74-year-old woman who had presented with a malignant fibrous histiocytoma of the right thigh previously treated with surgery and radiotherapy. Two years later she presented with signs and symptoms of tricuspid regurgitation and right ventri...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140216
更新日期:1991-02-01 00:00:00
abstract::The effects of monotherapy with atenolol or diltiazem-SR on blood pressure, 24-h blood pressure (BP) load, and exercise capacity were tested in patients with mild to moderate (stages I and II) essential hypertension. After 3-week single-blind placebo therapy, patients with sitting diastolic blood pressure (SDBP) of 94...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/clc.4960171209
更新日期:1994-12-01 00:00:00